Friday, December 31, 2010

We are featuring a childhood/infant disease or condition informational post every other Friday. Today's topic is Ear Infections.

Definition

Overview of Ear Infections

There are three main kinds of ear infections, which are called acute otitis (oh-TIE-tus) media (AOM), otitis media with effusion (uh-FEW-zhun) (OME), and otitis externa (Swimmer’s Ear). Sometimes ear infections can be painful and may even need antibiotics. Your healthcare provider will be able to determine what kind of ear infection you or your child has and if antibiotics would help.

Acute otitis media

The type of ear infection that is usually painful and may improve with antibiotic treatment is called acute otitis (oh-TIE-tus) media, or AOM. Symptoms of AOM include pain, redness of the eardrum, pus in the ear, and fever. Children may pull on the affected ear, and infants or toddlers may be irritable. Antibiotics are often prescribed to children for AOM, but are not always necessary.

Otitis media with effusion

Otitis media with effusion (uh-FEW-zhun), or OME, is a build up of fluid in the middle ear without signs and symptoms of acute infection (pain, redness of the eardrum, pus, and fever). OME is more common than AOM, and may be caused by viral upper respiratory infections, allergies, or exposure to irritants (such as cigarette smoke). The build up of fluid in the middle ear does not usually cause pain and almost always goes away on its own. OME will not usually benefit from antibiotic treatment.

Otitis externa (Swimmer’s Ear)

Otitis externa, more commonly known as Swimmer’s Ear, is an infection of the ear and/or outer ear canal. It can cause the ear to itch or become red and inflamed so that head movement or touching of the ear is very painful. There may also be pus that drains from the ear. Antibiotics are usually needed to treat otitis externa.

Friday, December 17, 2010

We are featuring a childhood/infant disease or condition informational post every other Friday. Today's topic is Diabetes.

Definition

Diabetes is a condition in which people have abnormally high levels of sugar (glucose) in their blood. There are two main types of diabetes, Type 1 and Type 2.

Type 2 diabetes is by far the more common type of diabetes. It accounts for over 90% of all diabetes cases. Type 2 diabetes was once known as "adult-onset diabetes" but this term is no longer used because Type 2 is on the rise in all age groups, including among children. Type 2 is increasing primarily because more children and adults are becoming overweight and obese.

People with diabetes lose the ability to control the level of sugar in their blood. Sugar rises to excessive levels in the blood because it can't enter the cells of the body - in the usual way and because an excess of sugar is produced in the liver. So, for example, without sugar getting inside the muscle cells, these cells don't have enough fuel to keep the body working properly. The same is true for other cell types throughout the body. The main feature of type 2 diabetes is the body's resistance to the action of insulin in the cells. This is a condition known as insulin resistance. Obesity may be the single most important factor in the development of insulin resistance and type 2 diabetes.

As reported for Drugstore Canada by Judy Waytiuk, Manitoba pharmacists are one of the only Canadian health professions with individual voting authority over their practice regulations. This is unlike the rest of Canada, where the regulatory body consults on, sets and implements practice changes.

And so, lucky Manitoba pharmacists get to voice their concerns on important issues ranging from technicians’ scope of practice, to prescribing authority, to a position on inducements.

Input is not merely advisory in nature, and pharmacists get the respect they deserve…

True, the Manitoban-democratic-approach can potentially slow down and—to the horror of policy drafters—squash brilliant initiatives. But pondered delay is not only salutary, it is essential.

Sure, asking for full membership participation in proposed regulatory changes would be a tedious, time-consuming task, but as the Manitoba experience shows, the licensing body is better off for it.Never is this truer than when clouds loom dark on the horizon, something not uncommon in British Columbia… where, in fact, an event of unprecedented importance took place this year….

Welcome to Vancouver EGM 2010At the petition of 500 community pharmacists, an Extraordinary General Meeting (EGM) was convoked by the College of Pharmacists of British Columbia and held in Vancouver on July 13, 2010. Over 160 pharmacists from across the province took great pains to be present in order to voice their concerns over regulatory changes that will make technicians a new class of College registrant, authorizing them to perform final prescription checks and take verbal orders from physicians.

Highlighting this event was the resignation of Board members Doug Kipp and Bev Harris, who courageously stepped down—later to be re-elected in landslide wins—so they could speak out freely against College policy changes, bypassing a newly reinforced rule requiring all Board members to “Speak with One Voice” .

Later, the tidy Board-approved minutes would fail to capture the lively exchange that transpired on that historical July evening when over 160 pharmacists took the College to task, leaving those who were there with a taste of Orwellian Double-Speak…

There, a resolution was presented calling on the Board to “reconsider its decision to establish the profession of Regulated Pharmacy Technicians for community pharmacy”. It was supported and passed by an overwhelming majority.

Attendees were reminded, lest they forget, that due to the College’s overriding mandate to protect the public the vote would be only advisory in nature. However, they added, results would be given “due consideration” at the next regularly scheduled Board meeting in September. Pharmacists did not hold their breath.

Come September…On August 1st, just weeks after the EGM and over a month before the much-awaited September Board meeting, Ministerial approval of revised HPA Bylaws (inclusive of regulated pharmacy technicians) came into force. The changes will allow the College to bulldoze ahead in the New Year as planned, leaving pharmacists with the impression that “due consideration” of their resolution had never really been intended at all.

Having previously resigned her position, Bev Harris attended the September 24th Board meeting as an observer. “It all took about 30 seconds,” she told me.

The BC College of Pharmacists’ Board consists of elected members and non-pharmacist government appointees. At this meeting, one non-pharmacist moved the motion that the College go ahead as planned with technician regulation. This was seconded by another government appointee. The majority voted in favour, and so, it was…

No discussion ever took place.

And so it is that, in spite of unresolved concerns, the final step in the approval process regarding the legislative authority to register pharmacy technicians as registrants of the College of Pharmacists of BC is now complete.

After only eight months of training, technicians will be allowed to perform final med checks and take verbal orders. Meanwhile, pharmacists’ concerns—ranging from liability, to employment loss, to patient safety—remain unaddressed.

In all fairness, the College has expressed the need for “further communication and support to help manage change”. However, there is something terribly wrong with a professional governing body that appears to listen but fails to act on the concerns of its registrants, seeking instead to impose change by force. Alienation is the only possible outcome.

Re-education anyone?

Sure, asking for full membership participation in proposed regulatory changes would be a tedious, time-consuming task, but as the Manitoba experience shows, the licensing body is better off for it.

If anything, a more democratic governing model would ensure that our yearly dues were better spent. It would also shield the governing body against perceptions (however unfounded) of government run amok.

There is a huge effort today to protect the physical environment from the unintended effects of human activity. We have international agreements and national policies to reduce global warming by curbing excess carbon, produced as human beings pursue their material wellbeing. On a smaller scale, we each do our best to turn off the taps, turn down the lights, use public transport, cut down on the fumes, recycle, recycle, and definitely not flush any medicines down the sink – especially not the brain-altering or endocrine-disrupting kind. Yes, we are constantly seeking ways to reduce air and water pollution, and in Canada, the Environment Act even allows citizens to bring civil action when the government is not enforcing environmental laws.....(to read more click on title above)

Friday, December 3, 2010

We are featuring a childhood/infant disease or condition informational post every other Friday. Today's topic is Group B Strep.

Definition

Group B strep (GBS) is a type of bacteria that is often found in the vagina and rectum of healthy women. In the United States, about 1 in 4 women carry this type of bacteria. Women of any race or ethnicity can carry these bacteria. Being a carrier for these bacteria does not mean you have an infection. It only means that you have group B strep bacteria in your body.

Finding the GBS bacteria does not mean that you are not clean, and it does not mean that you have a sexually transmitted disease. The bacteria are not spread from food, sex, water, or anything that you might have come into contact with. They can come and go naturally in the body.

GBS can be passed from a mother to her baby during childbirth.

GBS is a leading cause of life-threatening infections in newborns, including pneumonia (lung infection), sepsis (blood infection), meningitis (infection of the lining of the brain and spinal cord), and other problems. Sadly, many infants can die or have serious long-term effects from a GBS infection.

Preventing Group B Strep in New Borns

Ask your doctor or nurse for a GBS test when you are 35–37 weeks pregnant (in your 9th month). The test is an easy swab of the vagina and rectum that should not hurt.

Each time you are pregnant, you need to be tested for GBS. It doesn't matter if you did or did not have this type of bacteria before; each pregnancy is different.

Carrying GBS bacteria does not mean that you are not clean, and it does not mean that you have a sexually transmitted disease. The bacteria are not spread from food, sex, water, or anything that you might have come into contact with. They can come and go naturally in the body.

The medicine to stop GBS from spreading to your baby is an antibiotic given during labor. The antibiotic (usually penicillin) is given to you through an IV (in the vein) during childbirth. If you are allergic to penicillin, there are other ways to help treat you during labor.

Antibiotics taken before labor will not protect your baby against GBS. The bacteria can grow back so fast that taking the medicine before you begin labor does not prevent the bacteria from spreading to your baby during childbirth.

Other people in the house, including kids, are not at risk of getting sick from GBS. If you think you might have a C-section or go into labor early (prematurely), talk with your doctor or nurse about your personal GBS plan.

More Information

To get more information about Group B Strep and its prevention in New Born Infants, go here.